Nutrition support in complications after bariatric surgery

Obesity is a disease, requiring timely operative intervention frequently. To the testimonies it is necessary to befit very carefully in connection with possible complications as violation of a digestive-transport function of gastrointestinal tract.     

Clinical Profile of Surgical Diseases with Emergence of New Problems in HIV+ Individuals

North Karnataka is one of the regions with the high prevalence of HIV+ individuals. Bijapur is a district in North Karnataka with high prevalence as per fact sheets of NACO of March 2012. Better awareness, access to health care, and antiretroviral therapy have improved survival and increase in number of people living with HIV/AIDS (PLHA). Improved survival has increased their attendance to hospitals with variety of surgical problems, some known and some less known. The percentage of HIV+ individuals was 1.64 % among all admissions. Of these individuals, 13.65 % (272) had surgical problems. Abscesses were the commonest. Abscesses at uncommon sites also were encountered. Anorectal pathologies, tuberculosis, lymphadenopathy, appendicitis, etc. commonly seen in HIV+ individuals were seen. Drug-induced pancreatitis due to anti retroviral therapy was one of the common problems encountered. Uncommon conditions like ureteric calculi, external iliac artery thrombosis, diaphragmatic eventration, and few more were observed. Even though literature on AIDS/HIV is abundant, there is less information on surgical conditions encountered more so from this part of the subcontinent. Hence, it was decided to report the profile of the conditions encountered.     

Management of unstable angina

One-hundred and seven patients with unstable angina were treated between 1981 and 1987. Platelet dysfunction and elevation of fibrinogen was observed. The efficacy of aspirin, dipyridamole and heparin on coagulation profile is compared. Left main disease was seen in 11.4 per cent. Left anterior descending was occluded in 90.7 per cent. Aortocoronary bypass graft using saphenous vein graft was carried out on all patients. On an average, each patients received 3.5 grafts. Emergency surgery was done in nineteen. Associated ventricular aneurysm was resected in nine. Thirteen patients died. Operative mortality decreased to nil in 1986–1987. Perioperative infarction was seen in five patients. Clinical improvement was seen in 80.3 per cent and 48.9 per cent were asymptomatic. Actuarial survival was 92 per cent after six years. Postoperative coronary angiography in 28 patients showed patency of grafts in 18, partial patency in six and occlusion in four. Aspirin was found useful after surgery to relieve angina. Spiroergometry and Thallium²⁰¹ scintigraphy was useful to assess medical and surgical treatment.     

Red cell tolerance of admixture with heated saline

Red cell stability in the face of thermal stress has been evaluated only in the setting of prolonged incubation. This study was conducted to determine red cell tolerance of rapid mixture with heated saline, which exposes red cells to heat only until thermal equilibration, which is a matter of seconds. Half-units of 35-day-old red cells stored in CPDA-1 were mixed at 6 to 10 degrees C in the blood container with an equal weight of 60, 70, or 80 degrees C saline. This resulted in mean mixture temperatures of 30.9, 37.5, and 42.6 degrees C, respectively. Controls consisted of the same mixture, but with 6 to 10 degrees C saline. The red cells in the mixtures were assessed for osmotic fragility, and the supernatant was examined for plasma hemoglobin and potassium. Neither osmotic fragility curves nor supernatant hemoglobin or potassium changed significantly with saline temperatures of 60 or 70 degrees C. When 80 degrees C saline was used, osmotic fragility, supernatant hemoglobin, and potassium all increased significantly (p less than 0.01) over control values. Red cells tolerate rapid mixture with 70 degrees C saline without hemolysis or change in osmotic fragility.     

Plastisity of secreteory neurons of hypothalamic supraoptic and paraventricular nuclei during light exposure

Changes of secreteory neurons of hypothalamic supraoptic (SON) and paraventricular nuclei (PVN) were analyzed using light and electron microscopy in 100 adult male rats from the first minutes up to 180 days after their round-the-clock 48 hours-long exposure to bright light. At the early stages after the exposure, SON and PVN cellular formula was changed in favor of functionally active neurons containing few secretory granules, large nucleus and nucleoli, low RNA content, sparse complexes of rough endoplasmic reticulum, vacuoles and lysosomes in their perikarya. After 24 hours in both SON and PVN and after 10 days in SON the number of cells accumulating secretion was greater than that in control group. Normalization of the cellular formula and of the structural organization of protein-synthesis apparatus in PVN secretory neurons took place at days 10-30, while those ones in SON--at days 30-180. The results obtained suggest that the range of plasticity in PVN neurons in animals exposed to continuous bright light is larger than that in SON neurons.     

Nationwide measles epidemic in Ukraine: the effect of low vaccine effectiveness

The WHO European Region has a measles elimination target for 2010. Between September 2005 and mid-June 2006, more than 50,000 measles cases were reported in Ukraine; many reportedly had received two doses of measles vaccine and over 60% were among persons 15-29 years old. To investigate vaccine effectiveness (VE), a case-control study was undertaken in Dnepropetrovsk region. VE for two doses of measles vaccine was 93.1%, providing insufficient population immunity for measles elimination. An additional dose of measles vaccine for these age-cohorts is required if Ukraine is to achieve measles elimination. Other republics of the former Soviet Union also need to consider a supplemental dose of measles vaccine for older age groups identified epidemiologically to be at increased risk for measles even though individuals may have already received two doses.